Neoadjuvant Chemotherapy and Surgery for MIBC: What’s a Successful Response?

Published in Discovery - Winter 2023

Neoadjuvant chemotherapy is the standard of care for cisplatin-eligible patients with MIBC who undergo radical cystectomy (removal of the bladder). But there has been some controversy as to how to define a successful response to neoadjuvant chemotherapy. Should the goal be a “pathologic complete response” – in other words, no cancer left after surgery? 

According to a recent Hopkins-led study, “There is mounting evidence to suggest that complete response as an endpoint may be reasonably broadened,” says medical oncologist Noah Hahn, M.D., Deputy Director of the GBCI, “to include patients with residual non-muscle invasive disease at the time of radical cystectomy.” 

In this study, the investigators found that patients who still had some non-muscle-invasive cancer present after neoadjuvant chemotherapy and surgery had “similar survival outcomes to patients with a complete pathologic response.” These findings were published in Urologic Oncology.